1. System Methods to Overcome Barriers
Margaret Hennessy MD
May 2016

2. Disclosure statement
I do not have a relevant financial, professional, or personal relationship with a commercial interest producing health care goods/services related to this educational activity.

3. How much does HCW recommendation matter?
Easy answer—A LOT!
Holman,JAMA Peds. 2014; 168(1):76-82
Barriers to HPV vaccine

4. Barriers to HPV vaccine
HCW
Parents
Parents will not like it
Financial/insurance
Knowledge gaps
Not sure about young teens
Not sure about boys
Physician did not recommend it
Wanted more info
Worry about young teens
Concern about new vaccine
Concern about finding a clinic that had vaccine

5. Recommendations Immunization Champion Start Early
Rooming process-in EMR/WIR
Provide scripting for staff
Monitor rates
Recall/Reminders

6. Champion Can be a nurse or physician Join listserv from CDC
Tune into Immunization Action Coalition
Disseminate information to all providers

7. Educate

8. Start Early We offer HPV vaccine at age 10 years
Improved immune response at early ages

9. Rooming Process Check WIR on all patients-sick or well
Bidirectional transfer of information from WIR and EHR
Staff to offer vaccines that are due to patient,VIS
Families that refuse, sign AAP refusal form
Provider then cued for discussion
Vaccinate

10. How do I bring up HPV vaccination?
Screen all teens from age 11 years & above
Don’t tip toe around the recommendation. You have to recommend it. “Your daughter is due for meningococcal, Tdap, and HPV vaccines today.” “HPV vaccine is very important since it protects against cancer.”
Train staff to know the facts so that they are your allies. Provide scripting for them.
Talk about vaccinating your own children. “I believe so strongly in this vaccine that I am giving it to my son..”

12. Don’t offer it. Recommend it.
Screen for vaccine status at every encounter. Don’t wait for well visits.

13. Check vaccine rates If you don’t measure it then you can’t improve it!
WCHQ will be adding HPV to panel in near future.

14. Reminder system

15. Next steps
Set up system for RECALL and REMINDERS

16. THE END